Individual
JOHN WALTON QUILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.D.A.C.
Contact information
Practice address
200 E BROADWAY AVE STE 305A, MARYVILLE, TN 37804-5780
(865) 579-4443
Mailing address
200 E BROADWAY AVE STE 305, MARYVILLE, TN 37804-5755
(865) 579-4443
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00897
TN
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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